Preoperative Red Cell Distribution Width and 30-day mortality in older patients undergoing non-cardiac surgery: a retrospective cohort observational study

Increased red cell distribution width (RDW) is associated with poorer outcomes in various patient populations. We investigated the association between preoperative RDW and anaemia on 30-day postoperative mortality among elderly patients undergoing non-cardiac surgery. Medical records of 24,579 patients aged 65 and older who underwent surgery under anaesthesia between 1 January 2012 and 31 October 2016 were retrospectively analysed. Patients who died within 30 days had higher median RDW (15.0%) than those who were alive (13.4%). Based on multivariate logistic regression, in our cohort of elderly patients undergoing non-cardiac surgery, moderate/severe preoperative anaemia (aOR 1.61, p = 0.04) and high preoperative RDW levels in the 3rd quartile (>13.4% and ≤14.3%) and 4th quartile (>14.3%) were significantly associated with increased odds of 30-day mortality - (aOR 2.12, p = 0.02) and (aOR 2.85, p = 0.001) respectively, after adjusting for the effects of transfusion, surgical severity, priority of surgery, and comorbidities. Patients with high RDW, defined as >15.7% (90th centile), and preoperative anaemia have higher odds of 30-day mortality compared to patients with anaemia and normal RDW. Thus, preoperative RDW independently increases risk of 30-day postoperative mortality, and future risk stratification strategies should include RDW as a factor

The diagnostic and prognostic value of red cell distribution width in cardiovascular disease, current status and prospective

The red blood cell distribution width (RDW) is an index of the heterogeneity of circulating red blood cell size, which along with other standard complete blood count (CBC) parameters are used to identify hematological system diseases. Besides hematological disorders, several clinical studies have shown that an increased in the RDW may be associated with other diseases including acute pancreatitis, chronic kidney disease, gastrointestinal disorders, cancer, and of special interest in this review, cardiovascular disease (CVD). The diagnostic and prognostic value of RDW in different CVD (acute coronary syndrome, ischemic cerebrovascular disease, peripheral artery disease, atrial fibrillation, heart failure, and acute ischemic stroke) has been reviewed in this article, to provide an understanding how its measurement may be applied to improve the management of these conditions.Keywords: RDW, Biomarker, Cardiovascular disease

Thrombin generation assays (TGAs)

In recent years, there has been a revival of interest in a time-honored tool of the clotting trade: the thrombin generation curve or thrombin generation (TG) assay (TGA) as we now call it. Thrombin generation is a key coagulation process that determines the extent of a hemostatic plug or a thrombotic process. The recent development of newer tests based on the continuous registration of TG under in vitro conditions that mimic more closely what occurs in vivo prompted us to reinvestigate the balance between procoagulants and anticoagulants in patients. Measurement of TG is accepted as a research tool, but the variety of sources and concentrations of reagents, as well as technical constraints, limit its potential for proper clinical use. The newer TGAs not only provide an overall assessment of hemostasis but also provide promising laboratory tools for investigating hemorrhagic coagulopathies and monitoring replacement therapy in several clinical conditions

Red blood cell distribution width is significantly associated with aging and gender.

Red blood cell distribution width is significantly associated with aging and gender

Serum but not urine concentration of neutrophil gelatinase-associated lipocalin is influenced by acute leukocyte variations.

Serum but not urine concentration of neutrophil gelatinase-associated lipocalin is influenced by acute leukocyte variation

Inhibition of xanthine oxidase and exercise on serum uric acid, 25(OH)D3, and calcium concentrations.

BACKGROUND: It has been shown that serum concentrations of 1,25(OH)2D3 are decreased in patients with gout. A short-term administration of allopurinol increases plasma concentrations of 1,25(OH)2D3 in mild to moderate renal failure, with or without hyperuricemia. It has been reported that subjects who perform regular vigorous and/ or moderate physical activities have higher plasma and serum 25(OH)D3 levels. However, little is known about the influence of allopurinol and/or physical exercise on serum 25(OH)D3 concentrations in humans. METHODS: We investigated the effect of allopurinol administration and/or physical activity on vitamin D metabolism by measuring serum uric acid, 25(OH)D3, and calcium levels in twelve professional soccer players. RESULTS: The athletes supplemented with allopurinol, but not those who received placebo, exhibited a significant decrease in uric acid serum concentrations after the match. We also found a significant increase in serum calcium and 25(OH)D3 concentrations in the supplemented group. CONCLUSIONS: We conclude that allopurinol administration might be an effective drug to lower hyperuricemia and treat hypovitaminosis D